Cost variation in diabetes care delivered in English hospitals

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Abstract

Background:

Many diabetic patients are admitted to hospital, where care is costly and where there may be scope to

improve efficiency.

Aims:

We analyse the costs and characteristics of diabetic patients admitted to English hospitals and aim to

assess what proportions of cost variation are explained by patient and hospital characteristics.

Methods:

We apply a multilevel approach recognising that patients are clustered in hospitals. We first analyse the

relationship between patient costs and their characteristics, such as HRG, age, gender, diagnostic

markers and socio-economic status. We derive the hospital fixed effect and adjust for hospital

characteristics such as number of patients treated, factor prices and number of specialties involved in

diabetes care. We rank hospitals by their adjusted fixed effect, which measures the extent to which their

costs vary from the average after controlling for patient and hospital characteristics. We conduct

sensitivity analysis to alternative specifications including different sets of covariates and subsamples.

Data:

We use Hospital Episode Statistics and reference costs for all patients admitted to diabetes care for all

English hospitals for the financial year 2005/06. Our sample includes 31.371 admitted patients in 148

hospitals.

Results:

Much of the variation in costs is driven by patient characteristics. Even so, around 8-9% of the

variation in costs is across hospitals. Geographical variation in factor prices is significant for cost of

diabetes care. The volume of patients, the number and diversity of specialties involved in caring for

diabetics was rejected as significant cost drivers. .

Conclusion:

Health Resource Groups (HRGS) and diagnostic markers are significant patient-related cost drivers in

diabetes care. Costs are not lower in hospitals with high volume of patients and where diabetes care is

concentrated in few specialties.

OriginalsprogEngelsk
TitelProceedings
Antal sider21
ForlagHealth Economics Study Group (HESG)
Publikationsdato2009
Sider1
StatusUdgivet - 2009
BegivenhedHealth Economics Study Group conference Sheffield 22-24 July 2009 - Sheffield, Storbritannien
Varighed: 22. jul. 200924. jul. 2009

Konference

KonferenceHealth Economics Study Group conference Sheffield 22-24 July 2009
Land/OmrådeStorbritannien
BySheffield
Periode22/07/200924/07/2009

Emneord

  • Diabetes mellitus, hositalsomkostninger, England, multilevel regression, omkostningsvariation

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